Surgery Improves Late-Stage Breast Cancer

Sept. 22, 2009 (Berlin) -- Women whose breast cancer is diagnosed late, when it has already spread to other parts of the body, live about a year and a half longer if their breast tumor is surgically removed, researchers report.

The main treatment for most breast cancers is surgery to remove either the affected part of the breast or the entire breast. But if the cancer has spread, surgery is typically offered only if the breast tumor is causing pain or other symptoms, says Jetske Ruiterkamp, MD, a surgical resident at Jeroen Bosch Hospital in Den Bosch, Netherlands.

To find out if surgery would improve their survival, the researchers reviewed the medical records of 728 women whose breast cancer was diagnosed at a late stage. Forty percent of them had surgery to remove the main breast tumor.

The median survival was 31 months in women who had surgery, compared with only 14 months for women who did not. Looked at another way, 24.5% of those who had surgery were still alive five years later vs. 13.1% of those who did not.

Even after taking into account age, period of diagnosis, the number of sites the disease had spread to, and different types of treatment, surgery reduced the risk of death by roughly 40%, Ruiterkamp says.

The results were presented at the joint meeting of the European Cancer Organization and the European Society of Medical Oncology (ESMO).

Up to 10% of women with breast cancer are diagnosed at a later stage, when the cancer has already spread, Ruiterkamp tells WebMD. The study's findings, if confirmed, could lead to major changes in their treatment, she says.

In the meantime, such women might want to discuss surgery with their doctors, Ruiterkamp says.

ESMO President Jose Baselga, MD, chairman of the medical oncology service at the Vall d'Hebron University Hospital in Barcelona, Spain, says that there are now a number of studies suggesting the surgery can extend survival of late-stage breast cancer patients.

Baselga tells WebMD that he believes that the surgery attacks the tumor's roots.

"The primary tumor is like a reservoir for self-seeding cancer stem cells" that fuel the cancer's growth and spread, Baselga explains.

Excising the tumor reduces the number of circulating tumor cells throughout the body, he says.

Ruiterkamp agrees, adding that it is also possible that surgery reactivates the immune system to attack the cancer.